RESUMEN
OBJECTIVE: To develop a consensus document containing clinical recommendations for the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND). METHODS: We assembled a panel of experts appointed by GeSIDA and the Secretariat of the National AIDS Plan (PNS), including internal medicine physicians with expertise in the field of HIV, neuropsychologists, neurologists and neuroradiologists. Scientific information was reviewed to October 2012 in publications and conference papers. In support of the recommendations using two levels of evidence: the strength of the recommendation in the opinion of the experts (A, B, C) and the level of empirical evidence (I, II, III), two levels based on the criteria of the Infectious Disease Society of America, already used in previous documents GeSIDA/SPNS. RESULTS: Multiple recommendations for the clinical management of these disorders are provided, including two graphics algorithms, considering both the diagnostic and possible therapeutic strategies. CONCLUSIONS: Neurocognitive disorders associated with HIV infection is currently highly prevalent, are associated with a decreased quality of life and daily activities, and given the possibility of occurrence of an increase in the coming years, there is a need to adequately manage these disorders, from a diagnostic as well as therapeutic point of view, and always from a multidisciplinary perspective.
Asunto(s)
Complejo SIDA Demencia/diagnóstico , Complejo SIDA Demencia/terapia , Algoritmos , HumanosRESUMEN
Disruption of neurocognitive functioning is one of most frequent complications in patients with HIV infection nowadays. The Highly Active Antiretroviral Therapy (HAART) has demonstrated an improvement associated with its use, although there are different works that show this improvement is achieved in a low proportion of individuals who initiate therapy. The most known characterization of neurocognitive dysfunction is the HIV-associated Dementia (HAD), yet there may also exist the asymptomatic neurocognitive impairment (ANI) or the Minor Cognitive-Motor Disorder (MCMD). This review describes the disorders related to HIV infection, and comments on possible interventions focused on the protection of neurocognitive functioning in HIV-infected people.
Asunto(s)
Trastornos del Conocimiento/virología , Infecciones por VIH/complicaciones , Enfermedades del Sistema Nervioso/virología , HumanosRESUMEN
BACKGROUND AND OBJECTIVE: The request for serological tests for HIV, HBV and HCV is usual amongst acute psychiatric inpatients. Nevertheless, the seroprevalence and the repercussion of a positive result have been scarcely studied. PATIENTS AND METHOD: Serological requests for these viruses were retrospectively analyzed in a sample of 332 psychiatric inpatients. RESULTS: Serological tests were requested by 65.3% patients. The prevalence of any seropositivity was 7.3%: 1.4% were infected by HIV-I, 3.2% had been in contact with HBV but none had an active infection, and 5.1% were infected by HCV. The presence of a positive result did not change the psychiatric therapeutic approach in any case. CONCLUSIONS: The low prevalence of seropositivity suggests that such tests should be performed selectively in patients who present risk factors or atypical psychiatric symptoms.